Elite Diagnostic and Medical Group

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

ELITE DIAGNOSTIC AND MEDICAL GROUP

Practice address

885 S Atlantic Blvd
Monterey Park, CA 91754-4733

Phone

(626) 281-9111

NPI assigned

Jul 8, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. William Lee, DO

Title

President

Phone

(626) 281-9111

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kendrick NG, DO

  • Internal Medicine Physician
  • Monterey Park, CA
  • NPI 1225002231

  Family Medicine

  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282608000000",
    "number": "1285667063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "885 S ATLANTIC BLVD",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917544733",
            "telephone_number": "626-281-9111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "885 S ATLANTIC BLVD",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917544733",
            "telephone_number": "626-281-9111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE DIAGNOSTIC AND MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-08",
        "last_updated": "2010-08-24",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-281-9111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX55190",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ131022",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX80950",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0101100",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Edmond Lee DPM, Inc.
• Edward Chen Perinatology Corp
• Edward Z Xu Medical Inc
• Jordan Lavell Edwards
• Elite Atlantic Foot & Ankle Clinic
• Emotional Health Association Share
• Employee Health Systems Medical Group
• En M Lai D.O. Inc
• Rommel Endozo
• Eng Medical Associates

• Family Medicine Physician in Monterey Park, CA
• Providers in Monterey Park, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.